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schizophrenia 1 month of at least two of the following: delusions hallucinations disorganized speech disorganized behavior negative symptoms positive/psychosis disorganized negative
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delusions What types of schizophrenic delusions have you heard of? persecution grandeur control reference
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hallucinations What kinds of schizophrenic hallucinations have you heard of?
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disorganized speech tangentiality derailment neologisms clanging A.K.A. THOUGHT DISORDER
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disorganization DISORGANIZED BEHAVIOR inappropriate affect bizarre behavior
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negative symptoms alogia (few words) affective flattening avolition (lack of motivation) social withdrawal
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age of onset stats 1% prevalence equal sex ratio course: better for women
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medication ANTIPSYCHOTICS (A.K.A. neuroleptics) treats + symptoms side effect: tardive dyskinesia TYPICALATYPICAL treats + & - symptoms? less side effects? 10x price 74% noncompliance w/in 18 mo
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major depressive episode depressed mood or loss of interest/pleasure appetite or body weight change (5%+) sleep problems psychomotor agitation or retardation fatigue feelings of worthlessness or guilt poor concentration thoughts of death or suicide (distress or impairment) For 2 weeks, 5+:
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manic episode inflated self-esteem/grandiosity less need for sleep excessively talkative racing thoughts too easily distracted increased goal-directed activity/ psychomotor agitation excessive pleasurable but risky activities 1 week of elevated, expansive, or irritable mood and 3+:
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mixed manic episode Meets criteria for both major depressive episode & manic episode. hypomanic episode Less severe than mania & does not cause impairment (at least 4 days)
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unipolar mood disorder Major Depressive Disorder, single episode (rare!) Major Depressive Disorder, recurrent
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bipolar I disorder a manic episode bipolar II disorder hypomanic episode + major depressive episode the following are all chronic w/ poor prognosis
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antidepressant meds TRICYCLICS – monoamine reuptake inhibitor MAO-Is – inhibits the enzyme that breaks down monoamines (tyramine & the cheese effect) SSRIs – selective serotonin reuptake inhibitor
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mood stabilizers LITHIUM (therapeutic vs. lethal dosage window) -kidney dysfunction & seizures ANTICONVULSANTS (valproate, carbamazepine) - Less effective than lithium for suicide
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ECT 65-140 volts for half second produces seizure for 30 secs to few minutes. Applied 3x/week for 4 weeks.
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generalized anxiety disorder 6 mo+ of uncontrollable worry to many issues 3+ of: restlessness, fatigue, poor concentration, irritable, muscle tension, sleep probs distress or impairment CRITERIA
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benzodiazepines Valium Librium Xanax Also used for sleeping pills & anti-seizure meds
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panic attack inappropriate fear response CRITERIA 4+ of: heart palpitations, sweating, shaking, short of breath, choking, chest pain, nausea, dizzy, derealization/depersonalizaiton, fear of losing control, fear of dying, chills/heat, numbness/tingling
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panic attack cued – conditioned to external cues uncued – conditioned to interoceptive cues situationally predisposed
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panic disorder CRITERIA recurrent panic attacks 1+ for 1 mo+: - concern about future attacks or consequences - sig behavioral change (avoidance of external or internal cues)
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panic disorder prevalence 3% 2:1 sex ratio onset teens-40 yrs rels 8x more likely concordant TREATMENT medications cued: systematic desensitization uncued: induce interoceptive sensations + cognitive restructuring of perceived control
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agoraphobia CRITERIA anxiety about situations where: - hard to access help - escape difficult/embarrassing
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specific phobia CRITERIA 6+ mo persistent, excessive, irrational fear of an object of situation anxiety/fear on exposure avoided or endured w/ intense anxiety insight that phobia is irrational
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specific phobia 9% prevalence 4:1 sex ratio prognosis: chronic CAUSE direct or vicarious trauma exp or conditioning from panic attack, information transmission TREATMENT systematic desensitization
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social phobia CRITERIA fear of social/performance situations anxiety/fear upon exposure insight that fear is irrational avoidance behavior impairs functioning
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social phobia 7% prevalence 1: 1 sex ratio onset: adolescence CAUSE prepared learning of social disapproval or, neuroticism/inhibition, conditioned direct exp TREATMENT MAO-Is, systematic desensitization, cognitive therapy
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OCD CRITERIA recurrent & persistent thoughts/images associated behaviors compelled to perform insight to irrational “ distress, consumes 1+ hr/day, or impairs functioning
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ocd obsessions repetitive, unwelcome thoughts compulsions repetitive, almost irresistible action germs something bad will happen symmetry religion #s washing counting checking touching rituals
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OCD 1% prevalence sex ratio? onset: childhood-30’s (earlier in males) prognosis: chronic thought-action fusion (belief that thought is equivalent of the behavior) TREATMENTS SSRIs, exposure & response prevention
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